Organization Active NPI

Paul R Whitwam MD PC

  • Surgery Physician
  • Roswell, NM
National Provider Identifier
1407962707
Registry record updated Dec 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
73-226 Issued in NM
Legal business name
PAUL R WHITWAM MD PC
Practice address
1600 SE Main St Ste F
Roswell, NM 88203-5423
Phone
(575) 623-3333
Fax
(575) 623-1161
NPI assigned
Aug 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Cindy Vaughn
Title
Office Manager
Phone
(505) 623-1133

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X 73-226 NM Primary

Addresses

Primary practice location

1600 SE Main St Ste F
Roswell, NM 88203-5423

Mailing address

1600 SE Main St Ste F
Roswell, NM 88203-5423
Phone (575) 623-1133

Other identifiers 1

IdentifierTypeStateIssuer
23424MedicaidNM

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198108800000",
    "number": "1407962707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 SE MAIN ST STE F",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882035423",
            "telephone_number": "575-623-1133",
            "fax_number": "575-623-1161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 SE MAIN ST STE F",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882035423",
            "telephone_number": "575-623-3333",
            "fax_number": "575-623-1161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL R WHITWAM MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-21",
        "last_updated": "2007-12-20",
        "status": "A",
        "authorized_official_last_name": "VAUGHN",
        "authorized_official_first_name": "CINDY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "505-623-1133",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "NM",
            "license": "73-226",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "23424",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.